Social and Spatial Inequalities in Healthcare Use among People Living with Dementia in England (2002-2016)



Watson, James ORCID: 0000-0002-0238-1906, Green, Mark, Giebel, Clarissa ORCID: 0000-0002-0746-0566, Darlington Pollock, Frances and Akpan, Asangaedem ORCID: 0000-0002-1764-8669
(2022) Social and Spatial Inequalities in Healthcare Use among People Living with Dementia in England (2002-2016). Aging and Mental Health, 27 (8). pp. 1476-1487.

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Abstract

Introduction Healthcare services for people living with dementia (PLWD) are stretched, and government promises of increased funding remain undelivered. With the UK dementia population to surpass 1 million by 2024, and dementia care costs predicted to almost treble by 2040, it is essential we understand differences in healthcare use among PLWD. This study aimed to explore social and spatial variations in healthcare use among people diagnosed with dementia (2002-2016). Methods Data were derived from Electronic Health Records of Clinical Practice Research Datalink GP patients in England (n=142,302). To standardise healthcare contacts, rates of healthcare contacts per year were calculated for three primary (GP observations and medications) and three secondary healthcare types (Accident & Emergency attendances and, emergency and elective hospital admissions). Fully-adjusted generalised linear regression models were used to identify healthcare use variation by social and spatial groups. 12 models were generated, one for each healthcare type in early- and late-onset populations separately. Results This study highlights numerous social and spatial variations in healthcare use among PLWD. Among PLWD several groups tended to have healthcare service use more closely associated with negative outcomes, including a greater likelihood of A&E attendances and emergency and elective hospital admissions. These groups include: men, people from White ethnicity groups and people from more deprived and rural areas. Conclusions Systemic and social measures are needed to reduce variations in healthcare use inequalities in PWLD. These include greater healthcare continuity, health checks and medicines reviews, culturally appropriate services, better and more accessible treatment, and improved infrastructure.

Item Type: Article
Uncontrolled Keywords: dementia, inequalities, primary healthcare, routine data, secondary healthcare, socio-economic, spatial
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 20 Jul 2022 11:18
Last Modified: 03 Aug 2023 20:48
DOI: 10.1080/13607863.2022.2107176
Open Access URL: https://doi.org/10.1080/13607863.2022.2107176
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3159002